Sexuality and
relationships

Cancer or its treatment can affect the relationships you have now and any you may make in the future. These changes may impact on your sexuality.

Your role in the family may change. Treatment may mean you have less energy than you used to. For a while you may not be the main breadwinner and these changes can affect your sexual self-esteem.

Your relationship with your partner may change too. You both may worry about having sex again if you’ve had a break from it for a while. Your sex drive may have changed since treatment. It can help to be open with each other about how you feel and what you want.

It can be difficult to build new relationships. You may be unsure about what and when to tell a new partner. It can help to talk your worries over with family and friends.

Sex is a normal part of most people’s lives. If you want help for sexual problems, talk to your GP or specialist nurse. They may be able to put you in contact with a relationship therapist.

Changes in your roles and relationships

Cancer or its treatment can temporarily change your roles in your relationship or family.

You may find your relationships with friends change. Some friends may not be able to deal with your cancer, and you may find you lose touch with them. Sometimes this can feel like a rejection, which can lower your self-esteem. It’s important to focus on the friends who are able to support and listen to you.

During treatment or after surgery, you may not have the physical energy to do all the things around the house that you did before. Relatives and neighbours may get involved in lending a hand, and sometimes this can leave you with a sense of not being needed, or not having control over your life. You may feel that you’ve lost your place. Fulfilling your role as a mum, dad or the breadwinner makes up part of your sexual self-esteem, so a change in that role is difficult to deal with.

Your future plans may change as a result of cancer and its treatment. Whether you are single or part of a couple, you may have made all kinds of plans, spoken or unspoken, for your relationships or sex life. Some people look forward to their children leaving home so they have more time, money and privacy for a relationship. They may feel that having cancer at this stage of life takes this opportunity away. It’s very normal to grieve for this kind of loss.

When you’ve been through an experience of cancer, you may never be the same again. Your view of your life, your relationships, your job and your family may all change. Managing all this change can be difficult to deal with, but you can use this challenge to build your relationships.

Many people say they:

become more honest with their partner

stop putting off things they want to do – sexually or otherwise

start to be more realistic about life in general

take up new interests that they’ve been putting off for years.

Being open to change encourages healthy sexuality. You may need to develop a whole new style of openness and flexibility. For example, you might have always taken the lead in sex, and this may have to change now. Your favourite sexual positions may not be comfortable any more, temporarily or permanently. You may have seen sex as being entirely about intercourse. But if penetrative sex is impossible, you may want to start exploring other ways to have and give sexual pleasure.

You may worry that you will lose your current or potential partner if you can’t fulfil their sexual needs. Talking to a partner about sex can be difficult. But discussing your fears and worries about sex can help you both feel more comfortable with each other.

If you're single

If you want to start a new relationship, it can be difficult to decide what to tell a new partner about your cancer, and also when to tell them. We often make assumptions about what other people think or feel about us and fear rejection.

There’s no simple answer that will work well for everyone. You may find it helpful to think about how safe you feel in the new relationship, and whether you feel you can trust your new partner with very personal information. This is particularly important if you have a body change that you keep hidden and are anxious about revealing. With time, you’ll probably feel stronger and more able to discuss your cancer.

Before making a strong commitment to a new partner, you should make time to discuss your cancer, especially if it could affect the length of your life or has affected your fertility. Lasting relationships are based on honesty, and keeping your cancer from your new partner may affect your future together. A loving partner should accept you as you are, and if they don’t then they’re probably not the right partner for you.

If you need help, you can usually find support from family and friends.

Sex after cancer treatment - Susie's story

If you’re in a relationship

Whenever someone has an illness that’s affecting their romantic or sexual life, it’s helpful to think about what their relationship was like before. A relationship that was difficult before cancer was diagnosed probably won’t be any better afterwards. However, some couples come to a new understanding and love for each other as a result of coping with a shared challenge like cancer.

You can use this information to help prepare yourself for any changes in your sexuality. You and your partner can consider how to manage this aspect of your life. You might want to get more information or resources to help you feel in control of maintaining good sexual self-esteem while having treatment.

It may be your partner who is concerned about sex. Some people find it more upsetting to watch someone they care for go through surgery or other treatments than to go through it themselves.

After your treatment, both you and your partner may be aware of the transition you both have to make from being ill or a care-giver, to becoming sexual partners again. Your partner may feel afraid to touch you in case they hurt you. Some people incorrectly believe they might catch the cancer through sexual contact. Your partner may lose desire because of the changes you’ve gone through. They may also feel rejected if they don’t realise that your reduced sexual desire is due to the cancer or its emotional effects. Communication is important when you’re trying to maintain a happy relationship.

Coping with sexual difficulties

Changed sex drive

It’s also important to acknowledge that your partner’s sex drive may not be reduced. Sometimes it can even increase, if touch or being intimate helps reassure them in times of stress. It may be important to talk to your partner about other ways they can meet their sexual needs, such as masturbation. This can help reduce any frustration they’re feeling because they’re having less sexual contact. This may not be what you would ideally want, but it can be a useful way for both of you to meet your needs.

Even when sex is not possible, you may become more emotionally intimate through greater communication.

Starting again

Being open with each other can often have a positive effect on an intimate relationship. If having sex is a worry, it may help if you agree to avoid it for a while. This can take the pressure off and let you concentrate on rebuilding intimacy. You can focus on spending time together and going out, holding hands or kissing and cuddling. Learning to massage each other can be supportive.

If you have had a break in sexual contact, it may be important to start again and re-learn about sexual contact. When you’re rebuilding intimacy, you may need to start very slowly and gently.

Try caressing each other without a goal of penetration or orgasm. Remember that there are lots of loving and erotic activities other than intercourse.

Having cancer doesn’t mean you have to give up sexual contact completely. However, you may find you don’t miss sexual contact and that not having sex isn’t a problem for you.

Getting help

If you find you’re having difficulties with your sex life, ask for help sooner rather than later. It’s very common for people to delay asking for help with sexual issues. This may be because they’re embarrassed or because they’ve been focused on their recovery. Remember that sex therapists and counsellors are used to helping couples who have had problems for a while, which might mean their relationship has serious issues by the time they get help.

A good place to start is your GP surgery. There might be a counsellor or psychologist in the practice. If not, they will know how you can contact one. You could also talk to your hospital team or specialist nurse about which sexual health services are available locally. The College of Sexual and Relationship Therapists has a list of nationwide counsellors and therapists who can offer advice and support.

You can buy books and DVDs about sexual issues from shops or online. Often they aren’t on display in shops, so you may need to ask for them. Your local library may also have some useful books you can borrow.

Sex and relationship therapy

You may be concerned about seeking help for a sexual problem from a counsellor or psychological therapist. You may worry you might be labelled in some way. Remember that sex is a normal part of most people’s lives and that asking for help with a sexual problem is no different to asking for help with any other health concern.

You may think that all sexual problems are physical and that talking about how you feel won’t help. Sex therapy (psychosexual counselling) can help you think about and adjust to any physical changes and help you explore different ways of getting sexual satisfaction. It can be very reassuring to discuss any sexual problems you have. You may be able to talk to someone in your healthcare team who has expertise in working through sexual issues.

Sex therapists are trained to help you work through the different physical, emotional and relationship issues that may be having a negative impact on your sexual function or well-being. Even if your sexual issues have mainly been caused by your treatment, such as changes to your breast(s), the sex therapist will pay attention to each aspect of your sexual concerns.

The therapist will ask you a lot of questions to assess what’s worrying you and how they might help. You don’t have to answer any questions you feel uncomfortable about. It can sometimes take a couple of sessions of therapy before you feel happy enough to openly talk about your feelings and concerns.

A sex therapist can’t fix all your problems, but they’ll help you, and your partner if you have one, explore the issues and work out ways for you to get what you want. The therapist may suggest some exercises to help you overcome the problem, but you don’t have to follow their advice if you don’t want to or if you feel uncomfortable.

Some sex and relationship therapists also have medical or nursing qualifications. If you have a physical problem that’s affecting your sex life, they’ll be able to give you advice about it.

Featured group

This group is for cancer survivors and people who have finished treatment. It is a space to discuss things like the physical and emotional after effects of cancer, returning to work, or trying to move on with your life.

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